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Keywords:

  • fracture fixation;
  • finite element analysis;
  • aging;
  • bone yielding;
  • wire pre-tension

Abstract

The potential for peri-implant bone yielding and subsequent loosening of Ilizarov ring-wire external fixation systems was investigated using non-linear finite element (FE) analyses. A strain-based plasticity model was employed to simulate bone yielding. FE models also incorporated contact behavior at the wire-bone interface, orthotropic elasticity, and periosteal-endosteal variation of bone properties. These simulations were used to determine the extent and location of yielding with change in age-related bone structure and properties for the bone-Ilizarov construct at the tibial midshaft. At critical wire-bone interfaces, the predicted volume of yielded bone with four wires (on either side of the fracture) was ∼40% of that with two wires. Old-aged cases showed considerably greater bone yielding at the wire-bone interface than young cases (1.7–2.2 times greater volumes of yielded bone). The volume of yielded bone at all wire-bone interfaces decreased with an increase in wire pre-tension. The absence of continuous through-thickness yielding offers an explanation for the clinical observation that Ilizarov ring-wire fixation can provide stable fracture fixation even in bone with high porosity. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 30:726–732, 2012